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Treatment patterns and their outcomes of acute aortic intramural hematoma in real world: multicenter registry for aortic intramural hematoma

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Author(s)
Yoon-Jung ChoiJang-Won SonSang-Hee LeeUng KimDong-Gu ShinYoung-Jo KimSeung-Ho HurChang-Wook NamYun-Kyeong ChoBong-Ryul LeeByung-Chun JeongJin-Bae LeeJae-Kean RyuHun-Sik ParkJang-Hoon LeeSe-Yong JangJong-Seon Park
Keimyung Author(s)
Hur, Seung HoNam, Chang WookCho, Yun Kyeong
Department
Dept. of Internal Medicine (내과학)
Journal Title
BMC Cardiovascular Disorders
Issued Date
2014
Volume
14
Issue
1
Abstract
Background
Intramural hematoma of the aorta (IMH), a variant of classic aortic dissection, shows very dynamic process in the early phase. The aim of this study is to evaluate clinical outcomes of patients with acute aortic IMH from real world registry data.


Methods

We analyzed 165 consecutive patients with acute IMH from five medical centers in Korea. All patients were divided into two groups; type A (n = 61, 37.0%) and type B (n = 104, 63.0%) according to the Stanford classification. Clinical outcomes and morphological evolution by CT were analyzed for 2 years.


Results

Most of the patients (77.0% of type A and 99.0% of type B, P < 0.001) were treated medically during their initial hospitalization. There were no significant differences in in-hospital mortality (4.9% vs. 2.9%, P = 0.671) and 2-year mortality (13.1% vs. 11.5%, P = 0.765) between two groups. During the 2-year follow up period, progression to aortic dissection (18.0% vs. 6.7%, P = 0.037) and surgical treatment (29.5% vs. 2.9%, P < 0.001) were higher in type A. For the type A patients, there were no significant difference in in-hospital mortality (7.1% of surgery vs. 4.3% of medical, P = 0.428) and 2-year mortality (7.1% of surgery vs. 14.9% of medical, P = 0.450) in terms of initial treatment strategy.


Conclusion

For real world practice in Korea, most of IMH patients were treated medically at presentation and showed favorable outcomes. Thus, even in type A acute IMH, early medical treatment with alternative surgical conversion for selected, complicated cases would be a favorable treatment option.


Keywords
Intramural hematoma of the aorta – Survival rates – Treatment
Keimyung Author(s)(Kor)
허승호
남창욱
조윤경
Publisher
School of Medicine
Citation
Yoon-Jung Choi et al. (2014). Treatment patterns and their outcomes of acute
aortic intramural hematoma in real world:
multicenter registry for aortic intramural
hematoma. BMC Cardiovascular Disorders, 14(1), 103–103. doi: 10.1186/1471-2261-14-103
Type
Article
ISSN
1471-2261
DOI
10.1186/1471-2261-14-103
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35238
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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